Newly printed “no smoking” signs went up across China when the government rolled out a nationwide public indoor smoking ban in May 2011. A sticky gray layer of smoke residue now coats many signs, representing the challenges China’s growing tobacco-control movement faces against a multibillion-dollar government-run industry and deeply embedded social practices.

How has the cigarette become so integrated into the fabric of everyday life across the People’s Republic of China (PRC)?

To get to the heart of this question, historians, health policy specialists, sociologists, anthropologists, business scholars, and other experts met Mar. 26 and 27 in Beijing for a conference organized by Stanford’s Asia Health Policy Program. They examined connections intricately woven over the past 60 years between marketing and cigarette gifting, production and consumer demand, government policy and economic profit, and many other dimensions of China’s cigarette culture.

Anthropologist Matthew Kohrman, a specialist on tobacco in China, led the conference, which was held at the new Stanford Center at Peking University. In an interview, he spoke about the history of China’s cigarette industry, cigarettes and society, and the tobacco-control movement.

The early years

Tobacco first entered China through missionary contact in the 1600s, says Kohrman, but it was not until the early 20th century when cigarettes began gaining popularity. The first cigarette advertising was a “confused tapestry” of messages as marketers figured out what spoke to the public. “There were just as many images of neo-Confucian filial piety as there were of cosmopolitan ‘modern women,’” says Kohrman.

Through improved marketing and aggressive factory building, British American Tobacco and Nanyang Brothers, China’s two largest pre-war firms, helped increase the demand for cigarettes. The Sino-Japanese War (1937–1945) disrupted the cigarette supply, but their popularity had taken hold. Some cigarette firms shifted during the war to the relative safety of southwest China, where tobacco production has remained concentrated ever since.

Post-1949

After the founding of the PRC in 1949, the tobacco industry was nationalized and strong relationships between the central government and cigarette manufacturers in the provinces were formed. Cigarettes also began to be viewed as a part of everyday life. “Ration coupons for cigarettes were issued alongside grain, sugar, and bicycle coupons,” says Kohman. “The Maoist regime legitimized cigarettes as the right of every citizen."

During the Deng Xiaoping era (1978–1997), China’s cigarette industry really took off as manufacturers competed with one another for foreign currency to purchase cutting-edge European equipment and newer varieties of tobacco seed stock. Increased production and the return of full-scale advertising fueled greater consumer demand, and manufacturers began producing more and more varieties of cigarette. Vendors displayed glass cases filled with a colorful patchwork of cigarette packs bearing names like Panda, Double Happiness, and Red Pagoda.

The tobacco industry remained under government control as other industries privatized in the 1980s and 1990s. Party-state management of the cigarette became even more centralized in the early 1980s with the creation of the China Tobacco Monopoly Administration and its parallel external counterpart, the China Tobacco Corporation.

Since 1949, provincial protectionism has marked the cigarette market. It is now possible to purchase Beijing cigarettes in Kunming, Chengdu brands in Shanghai, and so on, but to distribute cigarettes in another province, a manufacturer must cut a deal with provincial government officials. Provincial administrations are loath to cut such deals because central government policy dictates that the portion of cigarette sales tax which does not go to the central government always is channeled to the finance bureau of the province of original production. China’s 2001 entry into the World Trade Organization opened the market ever so slightly to international brands like Marlboro and Kent, but domestic brands continue to dominate because of fierce protectionism.

...If it chooses to do so, China is in a position to lead and change the landscape in a very profound way.
-Matthew Kohrman, Professor of Anthropology, Stanford
A new era

In 2003, the World Health Organization established the first global health treaty, the Framework Convention on Tobacco Control (FCTC). Although the United States still has not yet ratified the FCTC, China signed the treaty in 2003 and ratified it in 2005. Kohrman says China’s tobacco industry giants fear competition from international cigarette brands more than they worry about tobacco-control measures related to the FCTC.

Nonetheless, the FCTC ushered in a new era of public health research about tobacco and has helped increase public awareness about the dangers of smoking. New restrictions have been imposed on print and television advertising for cigarettes, and international organizations, such as the Bloomberg Family Foundation, have begun funding anti-tobacco work in China.

A big challenge to tobacco-control campaigns, says Kohrman, is the sheer amount of money that tobacco companies have available for marketing. “In 2010, China’s tobacco industry posted profits in excess of U.S. $90 billion—that’s huge. Tobacco control research and advocacy now annually receive a few million dollars, and much of that is coming through outside funders, which have very specific projects in mind.”

China’s tobacco advertisers have adapted to the new restrictions that prevent them from openly promoting cigarettes in the media. They have instead moved to point-of-sale and soft-marketing tactics, including misinformation campaigns about the “dangers” of quitting smoking. “The actual expenditure on marketing probably hasn’t dropped very much,” says Kohrman.

Cigarettes and society

Strong marketing and the legitimization of cigarettes as a part of everyday life have led to the deep integration of cigarettes into Chinese society. While only 3 to 4 percent of women in China smoke, cigarettes are an important part of male identity and social mobility. The wide range of cigarette brands has led to the growth of high-end varieties favored by businessmen and politicians, with some brands costing as much as $50 a pack. The custom of cigarette gifting has existed in China for decades, and it is difficult for a young man to turn down a package of cigarettes from a senior colleague or supervisor.

There is also the fact that nicotine is highly addictive, and quitting is difficult in an environment where smoking cigarettes is socially sanctioned. Kohrman says, “When you take an incredibly addictive substance like nicotine and throw it into the mix of all of these norms and customs, it creates a pretty toxic brew.”

The future?

Tobacco control presents a formidable challenge in China, one that requires understanding the historical context and complex dimensions of the cigarette industry. “Cigarettes have been insinuated into so many aspects of daily life across China, and the market for this product has now become so closely enmeshed with matters of government finance and operations,” says Kohrman.

What happens in China could have implications for the entire world. “There’s a tobacco-induced human annihilation unfolding right now in almost every country and questions about how society and Big Tobacco are enmeshed, and how cigarette culture and government finance have become mutually supportive are pivotal,” says Kohrman. “Every country except Bhutan has legalized cigarette sales and is subject to many of the same general issues as China—only in China they’re on a much larger scale. But if it chooses to do so, China is in a position to lead and change the landscape in a very profound way.”   

While many of us here in the US wake up concerned about political, economic, and military unrest at home and abroad, billions still wake up with more basic, human security concerns, opened FSE director Rosamond L. Naylor in a plenary connecting climate, energy, food, water, and health.

Are we going to have enough to eat today? How am I going to feed my family or care for family members struggling with HIV/AIDS and other infectious diesease? Is there enough water to drink, bathe, and still water my crops?

Naylor emphasized the need to bring these human security issues back into the forefront of our global conscious. While these are 'humanitarian needs at the core', they are also related to national and international security.

"When people are desperate enough, and we've seen this particularly with the food price spike in recent years, they take to the streets, and sometimes when they take to the streets they realize they are disgruntled about a number of things in addition to food prices," said Naylor.

The Arab Spring and wave of rebellions throughout the Middle East last year demonstrate the connections between food security, unmet basic needs, and national security. It has been a chaotic time for world food markets, said Naylor.

Naylor's global statistics are discouraging. Over a billion people still suffer from chronic hunger and malnutrition, 1/5 don't have physical access to water, and roughly 1.6 billion are facing economic water constraints (do not have the economic resources to access available water). Food and water insecurity are exacerbating the incidence and transmission of infectious disease.

At a time when investment is sorely needed, the Hill has been making dramatic cutbacks in foreign assistance and foreign investment is falling short. Efforts made by the private sector, philanthropy, and civil society, while valuable, remain siloed. Opportunties are being missed by not addressing the interrelated nature of food and health issues.

Despite this dire outlook, Naylor offered solutions to help us rethink our development strategy.

1. Invest in more diversified and nutritious crops that have more climate adaptation potential.
2. Consider new irrigation strategies, particularly in areas like Africa where 96% of the continent is still not irrigated. Not large dams, but small, distributed irrigation systems that rely on solar and wind.
3. Integrate food and health programs and the way we think about domestic and productive water uses.

Naylor was joined on the panel by Jeff Seabright (Vice President, The Coca-Cola Company), Daniel Gerstein (Deputy Under Secretary for Science and Technology, U.S. Department of Homeland Security), and Geoff Dabelko (Woodrow Wilson International Center for Scholars). The panel was moderated by Frank Sesno (George Washington University and Planet Forward). Video of the plenary can be found below:

Chinese Vice President Xi Jinping recently visited the United States to meet with top officials and tour various cities. China experts followed the trip closely because Xi is anticipated to become China’s next president. Thomas Fingar spoke with the Shanghai Oriental Morning Post about the visit, and about the Obama administration’s Asia policy.

How will the Obama administration’s strategic adjustments towards the Asia-Pacific shape or influence Xi’s visit? Given the fast-changing environment and shift of power towards Asia, will there be any changes or differences in the United States’s treatment of China’s anticipated future leader?

The primary impact is likely to be on the discussions between Xi and his American interlocutors. I assume that U.S. officials will want to explain the announced strategic adjustments and that Xi will seek authoritative answers to questions that he and other Chinese leaders have about the objectives and implications of the adjustments.

Contrary to your question, I do not believe the environment is changing rapidly—shifts in the global system and the shift in dynamism and wealth toward Asia have been under way for decades. The United States has been and will remain a part of that transition. The U.S. goal is to ensure that the changes result in increased security and prosperity for all—a win-win situation not unlike what happened when first Japan and then the other “Asian tigers” preceded China on the path toward greater wealth and power. 

What interests Washington most about Vice President Xi? What expectations does the United States have for his visit?

Washington expects Xi to succeed Hu Jintao and understands that he will be first among equals in a collective leadership that constrains Xi’s ability to act independently. But U.S. officials also understand that Xi, like all leaders, brings personal preferences and agendas to the job and that dealing with him will be influenced by his personality, understanding of American culture, and goals for the relationship. Simply stated, the Americans Xi meets will want to get to know him and what he is like.

U.S. officials understand that he is here as China’s vice president and therefore is unlikely to be bringing new initiatives. They do expect him to have questions about U.S. and Obama administration positions on a wide range of global issues and to have questions about U.S. intentions in Asia.

Is the U.S. “pivot to Asia” strategy aimed at containing or encircling China? Almost all U.S. official statements try to clarify that the United States is not trying to contain China, but its policy focus and military deployments in the Asia-Pacific have made many Chinese scholars doubtful of U.S. intentions. What are your observations? Is U.S. rhetoric consistent with its actions?

I do not like the term “pivot to Asia” and am pleased that U.S. officials seem to have stopped using that term. The United States is not returning to Asia; we never left. I think the basic point of recent statements is that with the end of the U.S. role in the conflict in Iraq and plans to draw down in Afghanistan, the United States will be able to focus more attention on other parts of the world. Asia is, and has been, the most dynamic, fastest changing, and in many ways most-challenging region of the world for many years. The region is also very important to the United States and deserves more attention than it has received. The Asia-Pacific is a region of superlatives—biggest economies, largest militaries, most nuclear powers, largest military budgets, largest foreign exchange reserves, etc. It would be unwise and impossible not to pay attention to developments in and affecting the region and its relations with other parts of the global system.

I have been working on China for more than 45 years and working with Chinese counterparts for 40 years. I must say that I have just about abandoned efforts to persuade important groups in China that the United States is not attempting to surround, contain, or thwart China’s rise. They seem determined to believe that it is the case no matter what we say or do. It is impossible for me to look at the policies and actions of the last eight administrations and come to any conclusion except that the United States means what its leaders have said: that it is in the interest of the United States for China to be strong, secure, and prosperous. The record shows quite clearly that the United States has assisted China’s rise. It also shows that China’s rise has been beneficial to the United States. We are not poorer or weaker or more insecure because China’s people live better and China plays an increasingly important role on the world stage. 

Do you think the Obama administration has changed the direction of U.S. strategy toward China or Asia compared with the Bush administration?

The short answer is, “no. ” The Bush administration was preoccupied by terrorism, Iraq, and Afghanistan and devoted less time and attention to Asia. Obama is redressing the balance and better aligning attention with current interests. Arguably what has changed is the perception of China held by others in the region. A series of foreign policy blunders in 2010 undercut the success of China’s diplomacy and increased regional concern about China’s intentions. That prompted requests for reassurance that the United States would remain engaged in the region and that the Bush administration’s “neglect” of certain regional meetings was not a harbinger of a retreat from Asia. The Obama administration seeks to provide that assurance and to make clear that we are engaged in Asia because we are a Pacific power with great interests in the region. We are not there to contain or block anybody.

The United States is struggling with its economy and also cutting its defense budget. Do you think this strategy comes at the right time?

Downturns in the economy never come at a good time. The great recession has taken a heavy toll but we are recovering and will recover. We have been spending too much for too long and need to cut back. In my opinion, we also need to tax ourselves more to pay for modernization of infrastructure, better schools, and other requisites of continued prosperity. We are winding down two long and expensive wars and should reduce our defense budget. It will take time to replace worn out equipment and to reduce the large role that defense expenditures played in the U.S. economy during the Cold War, but we will get there eventually. More importantly, now is a good time to reduce defense expenditures and reorganize our military because we do not have any enemies and are not bent on conquering other nations.

Is the “pivot to Asia” strategy concrete or more of a “paper tiger” given the fact that other challenges, including Iran, are still occupying the United States?

As previously noted, the term “pivot to Asia” exaggerates the amount of change. The United States never left or lost interest in Asia, but is now able to devote more attention to the most dynamic, and in some respects most dangerous place in the world. Building a new security architecture that is inclusive—including China—and addresses concerns in and about North Korea is and should be a priority. Forging institutions to ensure continued stability and prosperity in the region despite paralysis at the global level and adjusting to changes in production and supply chains are among the long list of specific issues that need attention. The United States has a stake in the way these issues are addressed and must be engaged in the search for solutions.

PESD's new research on "Solar Lighting and Phone Charging in East Africa: Understanding Adoption, Business Model, and Development Outcomes" was awarded funding from the Freeman Spogli Institute's Global Underdevelopment Action Fund.

1.5 billion people worldwide lack access to electricity, severely impeding economic development and income generating activities.  The electricity access problem is most severe in sub-Saharan Africa, where it affects 700 million inhabitants. 

Rapid adoption of mobile phones has created even stronger incentives for low-income households to obtain the electricity needed to charge phones.  The emergence of businesses providing solar lighting and charging solutions could help satisfy that need. 

PESD’s research will study the factors that drive adoption of these solar lighting and charging technologies, the business models that are successful in delivering them on a commercial basis, and the development outcomes that derive from their use.

FSI’s venture fund was launched in the Summer of 2010 to help fund new research projects addressing global underdevelopment and poverty alleviation.  To date, the Action fund has contributed a total of $701,000 to these projects.